From Beyond The Rainbow Somewhere

Day: 05/26/2015

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Renewable energy is the future. All over the world cities and countries arevowing to go quit fossil fuels and commit to getting their energy fix from 100 percent renewable sources.

One of the most popular renewable options is solar—especially in areas that are, well, sunny. But in order to capture sunlight and turn it into electricity, you need solar cells, also known as photovoltaic cells.

With solar cells of particular interest to researchers, businesses, environmental groups, and just about everybody else, it always seems like there are new advances in research. Just last week, researchers at Aalto University published a paper in Nature Nanotechnology announcing that theycreated a black silicon solar cell with an efficiency of 22.1 percent. What does that mean, exactly? It sounds good, and Black Silicon would be a great name for a rock band, but how does it compare with everything else in the wide world of solar power?

Here are three of the most common types of solar cells that you might hear about, and what they do:

Crystalline Silicon: These are the solar cells dominating the market right now. In 2011, 90 percent of all solar cells were made from crystalline silicon. They can convert sunlight into electricity at a rate of 25 percent in ideal conditions. This is what other types of solar cells are measuring themselves against. The downside is these versions tend to be bulky.

Thin Film: Thin-film solar cells are less expensive to produce than crystalline silicon solar cells. Made from cadmium compounds, these cells are around 75 times thinner and can absorb sunlight better than silicon. Their flexibility and low weight makes them ideal as unobtrusive energy collectors. So why aren’t they at the top of the heap? Because they aren’t as good at converting sunlight to electricity as their crystalline silicon competitors… yet. Last year in the lab, thin-film technology reached a high of 20.4 percent efficiency. Not bad.

Black Silicon: Black silicon solar cells are similar to crystalline silicon solar cells. Really similar. The difference is that black silicon solar cells are treated so that they appear to be black on the surface. Why is that a big deal? Think of wearing a black T-shirt on a hot summer day. The black color tends to absorb more sunlight, which translates to an uncomfortable summer afternoon for you, but more energy gathered for a solar cell. It’s an attractive option for areas that don’t get as much sunlight but still want to make good use of the light they do receive. Until now, turning silicon cells black tended to undercut their efficiency at turning sunlight into power, however. That’s why the new paper, showing an efficiency of 22.1 percent is promising.

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Scientists at the University of York’s Centre for Quantum Technology have made an important step in establishing scalable and secure high rate quantum networks.

Working with colleagues at the Technical University of Denmark (DTU), Massachusetts Institute of Technology (MIT), and the University of Toronto, they have developed a protocol to achieve key-rates at metropolitan distances at three orders-of-magnitude higher than previously.

Standard protocols of Quantum Key Distribution (QKD) exploit random sequences of quantum bits (qubits) to distribute secret keys in a completely secure fashion. Once these keys are shared by two remote parties, they can communicate confidentially by encrypting and decrypting binary messages. The security of the scheme relies on one of the most fundamental laws of quantum physics, the uncertainty principle.

Today’s classical communications by email or phone are vulnerable to eavesdroppers but quantum communications based on single particle levels (photons) can easily detect eavesdroppers because they invariably disrupt or perturb a quantum signal. By making quantum measurements, two remote parties can estimate how much information an eavesdropper is stealing from the channel and can apply suitable protocols of privacy amplification to negate the effects of the information loss.

However, the problem with QKD protocols based on simple quantum systems, such as single-photon qubits, is their low key-rate, despite their effectiveness in working over long distances. This makes them unsuitable for adaptation for use in metropolitan networks.

The team, led by Dr Stefano Pirandola, of the Department of Computer Science at York, overcame this problem, both theoretically and experimentally, using continuous-variable quantum systems. These allow the parallel transmission of many qubits of information while retaining the quantum capability of detecting and defeating eavesdroppers. The research is published in Nature Photonics.

Dr Pirandola said: “You want a high rate and a fast connection particularly for systems that serve a metropolitan area. You have to transmit a lot of information in the fastest possible way; essentially you need a quantum equivalent of broadband.

“Continuous-variable systems can use many more photons but are still quantum based. Our system reaches extremely high speeds by three orders of magnitude higher than ever before over a distance of 25 kilometres. Its effectiveness above that distance decreases rapidly however.

“Nevertheless, our protocol could be used to build high-rate quantum networks where devices securely connect to nearby access points or proxy servers.”

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It’s only a centimeter long, it’s placed under your skin, it’s powered by a patch on the surface of your skin and it communicates with your mobile phone. The new biosensor chip developed at EPFL is capable of simultaneously monitoring the concentration of a number of molecules, such as glucose and cholesterol, and certain drugs.

The future of medicine lies in ever greater precision, not only when it comes to diagnosis but also drug dosage. The blood work that medical staff rely on is generally a snapshot indicative of the moment the blood is drawn before it undergoes hours – or even days – of analysis.

Several EPFL laboratories are working on devices allowing constant analysis over as long a period as possible. The latest development is the biosensor chip, created by researchers in the Integrated Systems Laboratory working together with the Radio Frequency Integrated Circuit Group. Sandro Carrara is unveiling it today at the International Symposium on Circuits and Systems (ISCAS) in Lisbon.

Autonomous operation

“This is the world’s first chip capable of measuring not just pH and temperature, but also metabolism-related molecules like glucose, lactate and cholesterol, as well as drugs,” said Dr Carrara. A group of electrochemical sensors works with or without enzymes, which means the device can react to a wide range of compounds, and it can do so for several days or even weeks.

This one-centimetre square device contains three main components: a circuit with six sensors, a control unit that analyses incoming signals, and a radio transmission module. It also has an induction coil that draws power from an external battery attached to the skin by a patch. “A simple plaster holds together the battery, the coil and a Bluetooth module used to send the results immediately to a mobile phone,” said Dr Carrara.

This biosensing chip has been created by researchers in EPFL’s Integrated Systems Laboratory. Credit: Alain Herzog / EPFL

Contactless, in vivo monitoring

The chip was successfully tested in vivo on mice at the Institute for Research in Biomedicine (IRB) in Bellinzona, where researchers were able to constantly monitor glucose and paracetamol levels without a wire tracker getting in the way of the animals’ daily activities. The results were extremely promising, which means that clinical tests on humans could take place in three to five years – especially since the procedure is only minimally invasive, with the chip being implanted just under the epidermis.

“Knowing the precise and real-time effect of drugs on the metabolism is one of the keys to the type of personalised, precision medicine that we are striving for,” said Dr Carrara.

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A list of inappropriate demands made of GPs has been published on the Resilient GP website, which supports doctors coping with heavy workloads.

Here are the highlights:

1

Is my nipple too hairy?

2

Is there a pill so I can have a baby boy?

3

I have ugly feet.

4

Do you have something to make my nails stronger & hair shinier before my holiday tomorrow?

5

Doctor, please tell my son to study harder so he can get into Eton.

(The child was six.)

6

My skin is too soft.

7

I get sore feet when I dance in high heels.

8

I’m addicted to crisps.

9

I have blisters on my hands since I started in the rowing club.

10

My lodger is annoying me… he’s spending too much time in his room.

11

Can I have a sick note for six months because I am nearly at retirement age?

12

Please can you fill out my driving licence application; I’m not sure how to.

13

Doctor, please can you write to my daughter’s school to say I’m finding the school run tiring and can they arrange transport to and from my house?

14

I’ve just been on holiday with my mistress… work want to know where I’ve been. I’d like a sick note to cover me.

15

I burnt the top of my mouth on pizza five days ago…

16

I am allergic to cats. I am getting a cat. Can I get a vaccination?

17

I’m allergic to avocados, if I eat eight I’m sick.

18

I’m really worried my daughter has a splinter… can you get it out? We haven’t tried by the way, because we were so worried.

19

I don’t know why I’m here doctor, my wife made the appointment.

Well shall we bring your wife in or telephone her perhaps?

We can’t. She’s in Portugal.

Dr John Cosgrove, a GP from Birmingham, said there was a serious point behind the list.

“It’s long been known that a lot of what GPs see is not necessarily amenable to medical treatment in the strict sense of the word. We’re quite happy to help people. But we’re just asking the question – is that the best use of us as a limited resource? With cuts in other services, we’re seen as a quick fix and we get very little in the way of extra support.”

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Summer is almost here, and many of us will be heading to the beach to cool off in the ocean. Have you ever considered what you might be swimming in? According to the EPA, up to 3.5 million people in the U.S. become ill from contact with raw sewage from sanitary sewer overflows each year. Swimming in polluted water can cause stomach flu, skin rashes, pinkeye, respiratory infections, meningitis, hepatitis and even a form of pneumonia called Legionnaire’s disease.

There are a couple things you can do to decrease your risk of getting sick from swimming in the ocean. Flooding from storms can cause sewage runoff that can pollute costal bodies of water; health officials recommend waiting at least 72 hours after a storm before going back into the water. Research from the Santa Monica Bay Restoration Project found an increased risk of infection for people swimming within 400 yards of a flowing storm drain, so be aware of your surroundings and avoid swimming near storm drains.

Swimming in lakes and streams can also cause health risks. Last summer, 70 people swimming in an Oregon lake caught a stomach virus from an infected swimmer. Smaller bodies of water are also in danger of pollution from sewage, livestock waste, and broken septic systems, all of which can cause serious illness. When entering a lake, you should look out for blue-green algae, also known as cyanobacteria, which can cause stomach pain, vomiting, and digestive issues when swimmers come in contact with it.

Health Threats from Polluted Coastal Waters (Beachapedia.org)
“The Surfrider Foundation, along with many county and state health departments has always advised the public never to swim or surf within 72 hours after a rain.”

Recreational Water Illnesses (CDC)
“Contrary to popular belief, chlorine does not kill all germs instantly. There are germs today that are very tolerant to chlorine and were not known to cause human disease until recently.”

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Summertime is all about enjoying the great outdoors. But there is a pesky little threat that could spoil your fun: insects like mosquitoes and ticks. The threats posed by insect bites are increasing, according to researchers, as climate change makes summers hotter and, in some places, wetter.

“One insect can spot you 150 feet away and actually zone in on you,” Dr. Clifford Bassett, medical director of Allergy and Asthma Care of New York, told “CBS This Morning.” “So you really don’t want to be a target.”

Bassett offered tips for how to protect yourself this summer:

What attracts mosquitoes?

“There are 400 compounds in our skin that are attractive to mosquitoes,” Bassett said. Mosquitoes are attracted to carbon dioxide in breath, sweat, higher body temperature, certain perfumes and scents, and pregnant women because they exhale more carbon dioxide than other people and have more blood circulating through their bodies. Research shows that the bodies of some individuals produce natural repellents to mosquito bites, which are genetically controlled.

Known health dangers from bug bites

Aside from the itchy skin, redness and swelling caused by mosquito bites, these insects can also carry dangerous viruses including West Nile and Chikungunya.

Who needs to worry about West Nile virus

According to Mayo Clinic, “most people infected with West Nile virus don’t experience any signs or symptoms, or may experience only minor ones, such as fever and mild headache. However, some people who become infected with West Nile virus develop a life-threatening illness that includes inflammation of the brain.”

Another insect to watch out for, ticks, can carry Lyme disease and other illnesses. Lyme disease is prevalent in the Northeastern U.S. and comes from the bites of infected deer ticks. Symptoms of Lyme disease include fever, rash, headache and fatigue. If caught early enough, the disease can be treated with antibiotics.

Ways to fight the bite

Bassett suggested that people pre-treat their skin with insect repellent before going outdoors. “There’s a study out now that shows that more natural plant-like chemicals work just as well as DEET,” he told CBS News. “Oil of lemon eucalyptus, Picaridin work really well for long periods of time.”

Bassett also advises wearing light colored clothing, long sleeves and long pants if you are planning on being in a wooded area. If you’re planning on hanging out in the backyard, Bassett suggested plugging in a fan outside. “A fan’s blowing on you — it prevents them [mosquitoes] from landing on you and prevents the bite,” he said.

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Boehringer Ingelheim today announced that the U.S. Food and Drug Administration (FDA) approved once-daily Stiolto Respimat (tiotropium bromide and olodaterol) Inhalation Spray. It has been approved as a long-term, once-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. Stiolto Respimat is not indicated to treat asthma or acute deterioration of COPD.
COPD, which includes chronic bronchitis and emphysema, is a serious but treatable lung disease. More than 15 million Americans have been told that they have COPD, but as many as 45 percent of the total estimated COPD cases in the U.S. remain undiagnosed. Patients are typically diagnosed when lung function is already significantly impaired. COPD symptoms can negatively impact a patient’s ability to breathe especially when performing daily activities.

“A recent review of landmark studies indicates that loss of lung function is more accelerated in the early stages of COPD. While no treatment slows the rate of decline, maintenance treatment with Stiolto Respimat initiated at the time of diagnosis will improve lung function,” said Danny McBryan, MD, vice president, Clinical Development & Medical Affairs, Respiratory, Boehringer Ingelheim Pharmaceuticals, Inc. Lung function was measured by trough FEV11 and FEV1 AUC0-3h.2
About Stiolto Respimat
“Stiolto Respimat is a COPD maintenance treatment proven to be more effective than either Spiriva or olodaterol alone, with a comparable safety profile,” said Sabine Luik, MD, senior vice president, Medicine & Regulatory Affairs, Boehringer Ingelheim Pharmaceuticals, Inc. “Patients may appreciate the benefits of a maintenance medication that improves lung function within five minutes, lasts all day and reduces the use of rescue inhalers.”

Long-acting beta2-adrenergic agonists, such as olodaterol, one of the active ingredients in Stiolto Respimat, increase the risk of asthma-related death. Stiolto Respimat is not indicated for asthma and should not be initiated in acutely deteriorating COPD patients or for the relief of acute symptoms. Stiolto Respimat is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, olodaterol, or any component of this product. As with other inhaled medicines, Stiolto Respimat may cause paradoxical bronchospasm that may be life-threatening. The most common adverse reactions were nasopharyngitis, cough and back pain.

“Stiolto Respimat produced greater lung function improvements in terms of FEV1 compared to tiotropium and olodaterol alone in patients with COPD across a range of disease severities (GOLD 2 to 4),” said Richard Casaburi, MD, PhD, professor and associate chief, Division of Respiratory and Critical Care Physiology and Medicine, Harbor-UCLA Medical Center. “As a clinician, I am pleased to have a new treatment option to offer my patients.” Tiotropium is a long-acting anticholinergic maintenance therapy and the active ingredient in Spiriva Respimat (tiotropium bromide) Inhalation Spray and Spiriva HandiHaler (tiotropium bromide inhalation powder). Since its approval more than 10 years ago, Spiriva has extensive clinical experience with over 40 million patient-years worldwide. Spiriva is the most prescribed COPD maintenance treatment in the U.S. and worldwide.

Olodaterol, approved for COPD patients as STRIVERDI® Respimat (olodaterol) Inhalation Spray, is a long-acting beta2-agonist maintenance treatment that improves airflow within five minutes after the first dose. Olodaterol does not replace the use of a rescue inhaler.

About the Respimat Inhaler
Stiolto is administered via Respimat, the platform inhaler for the Boehringer Ingelheim respiratory therapies, including approved and investigational therapies. Respimat is the only inhaler that actively delivers a slow-moving mist that helps patients inhale the medication.

The Respimat inhaler delivers medication independent of inspiratory effort. As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as coordination between actuation of the inhaler and inspiration through the delivery system. The duration of inhalation should be at least as long as the spray duration (1.5 seconds).

Stiolto is NOT indicated to treat acute deterioration of COPD and is not indicated to treat asthma.

Important Safety Information for Stiolto Respimat
WARNING: ASTHMA‐RELATED DEATH

Long-acting beta2-adrenergic agonists (LABA) such as olodaterol, one of the active ingredients in Stiolto Respimat, increase the risk of asthma-related death. Data from a large, placebo-controlled US study that compared the safety of another long-acting beta2-adrenergic agonist (salmeterol) with placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of all LABA, including olodaterol, one of the active ingredients in Stiolto Respimat. The safety and efficacy of Stiolto Respimat in patients with asthma have not been established. Stiolto Respimat is not indicated for the treatment of asthma.

Contraindication

All LABA are contraindicated in patients with asthma without use of a long-term asthma control medication. Stiolto is contraindicated in patients with hypersensitivity to tiotropium, ipratropium (atropine derivatives), olodaterol, or any component of this product.

In clinical trials and postmarketing experience with tiotropium, immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported. Hypersensitivity reactions were also reported in clinical trials with Stiolto.

Warnings and Precautions

Stiolto should not be initiated in patients with acutely deteriorating COPD, which may be a life-threatening condition, or used as rescue therapy for acute symptoms. Acute symptoms should be treated with an inhaled short-acting beta2-agonist. Patients who have been taking inhaled, short-acting beta2-agonists on a regular basis should discontinue the regular use of these drugs and use them only for acute respiratory symptoms.

Stiolto should not be used more often or at higher doses than recommended, or in conjunction with other LABA as an overdose may result.

Immediate hypersensitivity reactions, including urticaria, angioedema, rash, bronchospasm, anaphylaxis, or itching may occur after administration of Stiolto. If such a reaction occurs, discontinue therapy with Stiolto and consider alternative treatments. Patients with a history of hypersensitivity reactions to atropine or its derivatives should be closely monitored for similar hypersensitivity reactions to Stiolto.

If paradoxical bronchospasm occurs, Stiolto should be discontinued immediately.

Stiolto can produce a clinically significant cardiovascular effect in some patients, as measured by increases in pulse rate, systolic or diastolic blood pressure, and/or symptoms. If such effects occur, Stiolto may need to be discontinued.

Use caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, ketoacidosis, in patients with known or suspected prolongation of the QT interval, and in patients who are unusually responsive to sympathomimetic amines.

Use with caution in patients with narrow-angle glaucoma. Instruct patients to contact a physician immediately if signs or symptoms of acute narrow-angle glaucoma develop (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema).

Use with caution in patients with urinary retention, which can be associated with symptoms like difficulty passing urine and painful urination in patients with prostatic hyperplasia or bladder-neck obstruction. Instruct patients to consult a physician immediately should any of these signs or symptoms develop.

Patients with moderate to severe renal impairment (creatinine clearance of ≤60 mL/min) treated with Stiolto should be monitored closely for anticholinergic side effects.

Be alert to hypokalemia, which has the potential to produce adverse cardiovascular effects. Be alert to hyperglycemia.

Adverse Reactions

The most common adverse reactions with Stiolto (>3% incidence and higher than any of the comparators – tiotropium and/or olodaterol) were: nasopharyngitis, 12.4% (11.7%/12.6%), cough, 3.9% (4.4%/3.0%), and back pain, 3.6% (1.8%/3.4%).

Drug Interactions

Use caution if administering adrenergic drugs because sympathetic effects of olodaterol may be potentiated.

Concomitant treatment with xanthine derivatives, steroids, or diuretics may potentiate any hypokalemic effect of olodaterol.

Beta agonists, such as olodaterol, can acutely worsen the ECG changes and/or hypokalemia that may result from administration of non-potassium sparing diuretics. The action of adrenergic agents on the cardiovascular system may be potentiated by monoamine oxidase inhibitors or tricyclic antidepressants or other drugs known to prolong the QTc interval. Therefore beta-agonists should be used with extreme caution in patients being treated with these drugs. Drugs that prolong the QTc interval may be associated with an increased risk of ventricular arrhythmias.

Beta-blockers should be used with caution as they can inhibit the therapeutic effect of beta agonists which may produce severe bronchospasms in patients with COPD. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardio selective beta-blockers could be considered, although they should be administered with caution.

Avoid co-administration of Stiolto with other anticholinergic-containing drugs as this may lead to an increase in anticholinergic adverse effects.

Stiolto is for oral inhalation only. The Stiolto cartridge is only intended for use with the Stiolto Respimat inhaler.

Inform patients not to spray Stiolto into the eyes.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

About COPD
Chronic obstructive pulmonary disease (COPD) is a term including chronic bronchitis and/or emphysema. This disease can make breathing harder because less air is able to flow in and out of the lungs. Chronic lower respiratory diseases, which include COPD, are the third leading cause of death in the United States, and approximately 15 million Americans have been told by a healthcare provider that they have COPD.

The most common symptom of COPD is shortness of breath, especially with physical activities. Coughing, with or without mucus production, is also a common symptom of COPD. These symptoms can be misunderstood as signs of aging. COPD is usually associated with progressive airway damage and loss that cause breathing to get more difficult.

Leading Respiratory Forward
Through research, treatments and patient-centric support services, the Boehringer Ingelheim (BI) lung health portfolio is designed to help address the challenges people living with a lung disease face every day. Leveraging the company’s cutting edge science and leadership in chronic obstructive pulmonary disease (COPD), BI is researching new treatment approaches where needs persist. It is the company’s goal to make a difference in the lives of patients with COPD, asthma, lung cancer, idiopathic pulmonary fibrosis and other respiratory diseases.

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Wireless device slips under a mattress; a push to track patients on narcotic medications
Healthcare professionals monitor patients’ status at Houston Methodist Hospital by using a score known the Rothman Index.
Healthcare professionals monitor patients’ status at Houston Methodist Hospital by using a score known the Rothman Index.

Hospitals are trying new early-warning systems to monitor patients for subtle but dangerous signs of a worsening condition.

After surgery or during hospitalization for illness, patients are at risk for complications that can quickly turn fatal, such as a depressed breathing rate that can lead to cardiac arrest caused by over-sedation or an adverse reaction to narcotic pain medications. Patients can show signs of deterioration—known in medical terms as “decompensation”—as many as six to eight hours ahead of a cardiac or respiratory arrest, studies show.

But the signs aren’t always picked up or acted upon by staff. Patients on general medical and surgical floors are usually not monitored 24/7 unlike patients in intensive care units, who are hooked up to multiple machines and monitors.

Among the strategies hospitals are adopting is a wireless monitor that slips under a mattress and alerts nurses to changes in breathing and heart rate. Another approach rates a patient’s risk of serious deterioration in real time based on lab results, vital signs and nurses’ assessments gathered from electronic medical records.

“We have to be able to profile patients according to their risk, and then manage the high-risk group,” says David Westfall Bates, chief quality officer and chief of general internal medicine at Brigham and Women’s Hospital in Boston and a professor at Harvard Medical School.

The Rothman Index in use on a mobile phone. Children’s Hospital of Pittsburgh of UPMC has integrated PeraHealth’s Pediatric Rothman Index with their medical emergency response team to deliver alerts to doctors and nurses when a patient is in critical condition, anywhere in the hospital, at anytime. ENLARGE
The Rothman Index in use on a mobile phone. Children’s Hospital of Pittsburgh of UPMC has integrated PeraHealth’s Pediatric Rothman Index with their medical emergency response team to deliver alerts to doctors and nurses when a patient is in critical condition, anywhere in the hospital, at anytime. PHOTO: CHILDREN’S HOSPITAL OF PITTSBURGH OF UPMC
A study of 7,643 patient charts Dr. Bates co-authored last year in the American Journal of Medicine found that wireless monitors slipped under the mattress at Dignity Health’s California Hospital Medical Center in Los Angeles were linked to shorter hospital stays and a lower rate of “code blue” events (hospital lingo for a patient in immediate need of resuscitation or emergency medical attention), compared with units without the technology.

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The monitors, developed by EarlySense, based in Ramat Gan, Israel, also send alerts to nurses if patients get out of bed, and when it is time to turn them to avoid skin breakdown. Gladys Castro, nurse manager at California Hospital Medical Center, says that has helped prevent falls and bed sores.

Newton-Wellesley Hospital in Newton, Mass., uses EarlySense monitors throughout the hospital after starting a pilot program five years ago, says Perry An, chief operating officer of the division of hospital medicine. Dr. An says that they have helped warn staffers about issues that might otherwise have been missed. One alert revealed a low heart rate on a patient who turned out to have a blockage and subsequently had a pacemaker installed. In another case, an alert identified a patient on painkillers who was slipping into respiratory depression and was given medication to counter the effects.

The cost of EarlySense varies depending on hospital size, and how many features it includes. It can range from $80,000 to $200,000 for a 30-bed unit.

Pressure is mounting for hospitals to better identify patterns or changes before they get out of control. There is a national coalition of patient safety groups that is promoting continuous electronic monitoring of patients on narcotic pain medicines. The Centers for Medicare and Medicaid Services last year called for postoperative monitoring of patients on IV narcotics, regardless of where they are in the hospital, and said staff should educate patients and families to alert them if they notice any breathing problems.

Lenore Alexander, center, above, started a nonprofit organization to advocate for continuous electronic monitoring of patients on narcotics in the hospital. ENLARGE
Lenore Alexander, center, above, started a nonprofit organization to advocate for continuous electronic monitoring of patients on narcotics in the hospital. PHOTO: ROGER WU
According to the Joint Commission, a nonprofit organization that accredits hospitals and collects data on adverse events, 29% of narcotic-related adverse drug events including deaths, reported from 2004 to 2011 were from improper monitoring of patients. Recommended approaches to avoid such errors include finger sensors that measure oxygen levels in the blood and equipment that measures ventilation through patient’s exhaled breath, which are common in the ICU but not always used continuously on other units.

About 70 hospitals and health-care facilities are using a software program known as the Rothman Index, which costs about $150,000 for a medium-size 300-bed hospital. It was developed by brothers Michael and Steven Rothman after their mother, Florence, died in 2003 at age 87 after signs of deterioration were noticed too late following a routine heart procedure. Using information from 26 variables in medical records, it calculates a score from 1 to 100 and regularly updates it on a graph. Lower scores indicate closer monitoring or immediate help is needed.

The University of Pittsburgh Medical Center’s children’s hospital will roll out a pediatric version of the Rothman Index next month, after a study of the system published last month in Pediatric Critical Care Medicine found it could be a useful addition to staff evaluations. The aim is to update each child’s condition every 15 minutes and fire off an electronic page to a rapid response team of doctors and nurses if a patient’s condition falls below a certain level.

“Every child we admit is potentially vulnerable and we want to keep an electronic eye on every patient in the hospital,” says Robert Clark, chief of pediatric critical care medicine at Children’s Hospital of Pittsburgh of UPMC and a co-author of the study.

Houston Methodist Hospital in Texas started using the Rothman Index last July in two units and has since expanded it to nine additional units. In one three-month period the index identified 25 patients with deterioration so subtle that it wasn’t recognized by a doctor or nurse, says Katherine Walsh, a nurse and vice president of operations.

“This is not ever meant to replace good nursing care but it is a supplement that tells you there may be something you need to investigate,” Ms. Walsh says. The index also helps staffers determine when it is time to have discussions with patients and families about end-of-life care if a patient’s condition is declining irreversibly, Ms. Walsh says.

Yale-New Haven Hospital in Connecticut began adopting the Rothman Index in 2011, and is also partnering with Rothman Index owner PeraHealth Inc., based in Charlotte, N.C., to develop new applications. The hospital’s research has shown that the Rothman Index is a good predictor of which patients at discharge are at highest risk of having to come back to the hospital. It could be used to drive down readmissions, says Yale-New Haven Chief Medical Officer Thomas Balcezak.
Lenore Alexander started a nonprofit organization, LeahsLegacy, in 2013, to advocate for continuous electronic monitoring of patients on narcotics in the hospital. Her 11-year old daughter, Leah Coufal, died 12 years ago at Cedars-Sinai Medical Center in Los Angeles, after undetected respiratory arrest when she was on narcotic painkillers following surgery. A court case related to the death was settled.

“Monitoring is something we already have available to us that we could be using to save lives,” says Ms. Alexander, who is working with other nonprofit patient safety groups. While she doesn’t advocate for any particular company or equipment, she advises patients and families in the hospital to “ask how you will be monitored, how often and by whom.”

A Cedars-Sinai spokeswoman says patient privacy laws prevent discussion of specific cases but that all patients on narcotic pain medications are closely monitored, and patients at high risk for respiratory problems receive additional evaluation and care. “We are committed to helping our patients manage their pain while ensuring their safety,” she says.

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[WARNING] This list contains descriptions and images of human experimentation which may cause offense to some readers.

Human experimentation and research ethics evolved over time.

On occasion, the subjects of human experimentation have been prisoners, slaves, or even family members.

In some notable cases, doctors have performed experiments on themselves when they have been unwilling to risk the lives of others. This is known as self-experimentation.

This is a list of the 10 most evil and unethical experiments carried out on humans…

10. Stanford Prison Experiment

The Stanford prison experiment was a psychological study of human responses to captivity and its behavioral effects on both authorities and inmates in prison.

The experiment was conducted in 1971 by a team of researchers led by psychologist Philip Zimbardo at Stanford University. Undergraduate volunteers played the roles of both guards and prisoners living in a mock prison in the basement of the Stanford psychology building.

Prisoners and guards rapidly adapted to their roles, stepping beyond the boundaries of what had been predicted and leading to dangerous and psychologically damaging situations.

One-third of the guards were judged to have exhibited “genuine” sadistic tendencies, while many prisoners were emotionally traumatized and two had to be removed from the experiment early.

9. The Monster Study

The Monster Study was a stuttering experiment on 22 orphan children in Davenport, Iowa, in 1939 conducted by Wendell Johnson at the University of Iowa. Johnson chose one of his graduate students, Mary Tudor, to conduct the experiment and he supervised her research.

After placing the children in control and experimental groups, Tudor gave positive speech therapy to half of the children, praising the fluency of their speech, and negative speech therapy to the other half, belittling the children for every speech imperfection and telling them they were stutterers.

Many of the normal speaking orphan children who received negative therapy in the experiment suffered negative psychological effects and some retained speech problems during the course of their life.

Dubbed “The Monster Study” by some of Johnson’s peers who were horrified that he would experiment on orphan children to prove a theory, the experiment was kept hidden for fear Johnson’s reputation would be tarnished in the wake of human experiments conducted by the Nazis during World War II. The University of Iowa publicly apologized for the Monster Study in 2001.

8. Project 4.1

Project 4.1 was the designation for a medical study conducted by the United States of those residents of the Marshall Islands exposed to radioactive fallout from the March 1, 1954 Castle Bravo nuclear test at Bikini Atoll, which had an unexpectedly large yield.

For the first decade after the test, the effects were ambiguous and statistically difficult to correlate to radiation exposure: miscarriages and stillbirths among exposed Rongelap women doubled in the first five years after the accident, but then returned to normal; some developmental difficulties and impaired growth appeared in children, but in no clear-cut pattern. In the decades that followed, though, the effects were undeniable.

Children began to suffer disproportionately from thyroid cancer (due to exposure to radioiodines), and almost a third of those exposed developed neoplasms by 1974.

As a Department of Energy Committee writing on the human radiation experiments wrote,

“It appears to have been almost immediately apparent to the AEC and the Joint Task Force running the Castle series that research on radiation effects could be done in conjunction with the medical treatment of the exposed populations.” The DOE report also concluded that “The dual purpose of what is now a DOE medical program has led to a view by the Marshallese that they were being used as ‘guinea pigs’ in a ‘radiation experiment.”

7. Project MKULTRA

Project MKULTRA, or MK-ULTRA, was the code name for a CIA mind-control research program, run by the Office of Scientific Intelligence, that began in the early 1950s and continued at least through the late 1960s. There is much published evidence that the project involved the surreptitious use of many types of drugs, as well as other methodologies, to manipulate individual mental states and to alter brain function.

Experiments included administering LSD to CIA employees, military personnel, doctors, other government agents, prostitutes, mentally ill patients, and members of the general public in order to study their reactions. LSD and other drugs were usually administered without the subject’s knowledge and informed consent, a violation of the Nuremberg Code that the U.S. agreed to follow after WWII.

Efforts to “recruit” subjects were often illegal, even discounting the fact that drugs were being administered (though actual use of LSD, for example, was legal in the United States until October 6, 1966). In Operation Midnight Climax, the CIA set up several brothels to obtain a selection of men who would be too embarrassed to talk about the events. The men were dosed with LSD, and the brothels were equipped with one-way mirrors and the “sessions” were filmed for later viewing and study.

In 1973, CIA Director Richard Helms ordered all MKULTRA files destroyed. Pursuant to this order, most CIA documents regarding the project were destroyed, making a full investigation of MKULTRA virtually impossible.

6. The Aversion Project

South Africa’s apartheid army forced white lesbian and gay soldiers to undergo ’sex-change’ operations in the 1970’s and the 1980’s, and submitted many to chemical castration, electric shock, and other unethical medical experiments. Although the exact number is not known, former apartheid army surgeons estimate that as many as 900 forced ’sexual reassignment’ operations may have been performed between 1971 and 1989 at military hospitals, as part of a top-secret program to root out homosexuality from the service.

Army psychiatrists aided by chaplains aggressively ferreted out suspected homosexuals from the armed forces, sending them discretely to military psychiatric units, chiefly ward 22 of 1 Military Hospital at Voortrekkerhoogte, near Pretoria.

Those who could not be ‘cured’ with drugs, aversion shock therapy, hormone treatment, and other radical ‘psychiatric’ means were chemically castrated or given sex-change operations.

Although several cases of lesbian soldiers abused have been documented so far—including one botched sex-change operation—most of the victims appear to have been young, 16 to 24-year-old white males drafted into the apartheid army.

Dr. Aubrey Levin (the head of the study) is now Clinical Professor in the Department of Psychiatry (Forensic Division) at the University of Calgary’s Medical School. He is also in private practice, as a member in good standing of the College of Physicians and Surgeons of Alberta.

5. North Korean Experimentation

There have been many reports of North Korean human experimentation. These reports show human rights abuses similar to those of Nazi and Japanese human experimentation in World War II. These allegations of human rights abuses are denied by the North Korean government, who claim that all prisoners in North Korea are humanely treated.

One former North Korean woman prisoner tells how 50 healthy women prisoners were selected and given poisoned cabbage leaves, which all the women had to eat despite cries of distress from those who had already eaten.

All 50 were dead after 20 minutes of vomiting blood and anal bleeding. Refusing to eat would have meant reprisals against them and their families.

Kwon Hyok, a former prison Head of Security at Camp 22, described laboratories equipped respectively for poison gas, suffocation gas and blood experiments, in which 3 or 4 people, normally a family, are the experimental subjects. After undergoing medical checks, the chambers are sealed and poison is injected through a tube, while “scientists” observe from above through glass.

Kwon Hyok claims to have watched one family of 2 parents, a son and a daughter die from suffocating gas, with the parents trying to save the children using mouth-to-mouth resuscitation for as long as they had the strength.

4. Poison laboratory of the Soviets

The Poison laboratory of the Soviet secret services, also known as Laboratory 1, Laboratory 12 and “The Chamber”, was a covert poison research and development facility of the Soviet secret police agencies.

The Soviets tested a number of deadly poisons on prisoners from the Gulag (”enemies of the people”), including mustard gas, ricin, digitoxin and many others.

The goal of the experiments was to find a tasteless, odorless chemical that could not be detected post mortem. Candidate poisons were given to the victims, with a meal or drink, as “medication”.

Finally, a preparation with the desired properties called C-2 was developed. According to witness testimonies, the victim changed physically, became shorter, weakened quickly, became calm and silent and died within fifteen minutes. Mairanovsky brought to the laboratory people of varied physical condition and ages in order to have a more complete picture about the action of each poison.

In addition to human experimentation, Mairanovsky personally executed people with poisons, under the supervision of Pavel Sudoplatov.

3. The Tuskegee Syphilis Study

The Tuskegee Study of Untreated Syphilis in the Negro Male was a clinical study, conducted between 1932 and 1972 in Tuskegee, Alabama, in which 399 (plus 201 control group without syphilis) poor — and mostly illiterate — African American sharecroppers were denied treatment for Syphilis.

This study became notorious because it was conducted without due care to its subjects, and led to major changes in how patients are protected in clinical studies. Individuals enrolled in the Tuskegee Syphilis Study did not give informed consent and were not informed of their diagnosis; instead they were told they had “bad blood” and could receive free medical treatment, rides to the clinic, meals and burial insurance in case of death in return for participating.

In 1932, when the study started, standard treatments for syphilis were toxic, dangerous, and of questionable effectiveness.

Part of the original goal of the study was to determine if patients were better off not being treated with these toxic remedies.

For many participants, treatment was intentionally denied. Many patients were lied to and given placebo treatments—in order to observe the fatal progression of the disease.

By the end of the study, only 74 of the test subjects were still alive. Twenty-eight of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with congenital syphilis.

2. Unit 731

Unit 731 was a covert biological and chemical warfare research and development unit of the Imperial Japanese Army that undertook lethal human experimentation during the Second Sino-Japanese War (1937–1945) and World War II. It was responsible for some of the most notorious war crimes carried out by Japanese personnel.

Some of the numerous atrocities committed by the commander Shiro Ishii and others under his command in Unit 731 include: vivisection of living people (including pregnant women who were impregnated by the doctors), prisoners had limbs amputated and reattached to other parts of their body, some prisoners had parts of their bodies frozen and thawed to study the resulting untreated gangrene.

Humans were also used as living test cases for grenades and flame throwers. Prisoners were injected with strains of diseases, disguised as vaccinations, to study their effects.

To study the effects of untreated venereal diseases, male and female prisoners were deliberately infected with syphilis and gonorrhea via rape, then studied. A complete list of these horrors can be found here.

Having been granted immunity by the American Occupation Authorities at the end of the war, Ishii never spent any time in jail for his crimes and died at the age of 67 of throat cancer.

1. Nazi Experiments

Nazi human experimentation was medical experimentation on large numbers of people by the German Nazi regime in its concentration camps during World War II.

At Auschwitz, under the direction of Dr. Eduard Wirths, selected inmates were subjected to various experiments which were supposedly designed to help German military personnel in combat situations, to aid in the recovery of military personnel that had been injured, and to advance the racial ideology backed by the Third Reich.

Experiments on twin children in concentration camps were created to show the similarities and differences in the genetics and eugenics of twins, as well as to see if the human body can be unnaturally manipulated. The central leader of the experiments was Dr. Josef Mengele, who performed experiments on over 1,500 sets of imprisoned twins, of which fewer than 200 individuals survived the studies.

Dr. Mengele organized the testing of genetics in twins. The twins were arranged by age and sex and kept in barracks in between the test, which ranged from the injection of different chemicals into the eyes of the twins to see if it would change their colors to literally sewing the twins together in hopes of creating conjoined twins.

In 1942 the Luftwaffe conducted experiments to learn how to treat hypothermia. One study forced subjects to endure a tank of ice water for up to three hours (see image above). Another study placed prisoners naked in the open for several hours with temperatures below freezing. The experimenters assessed different ways of rewarming survivors.

From about July 1942 to about September 1943, experiments to investigate the effectiveness of sulfonamide, a synthetic antimicrobial agent, were conducted at Ravensbrück.

Wounds inflicted on the subjects were infected with bacteria such as Streptococcus, gas gangrene, and tetanus. Circulation of blood was interrupted by tying off blood vessels at both ends of the wound to create a condition similar to that of a battlefield wound. Infection was aggravated by forcing wood shavings and ground glass into the wounds.

The infection was treated with sulfonamide and other drugs to determine their effectiveness.

Methods and Results—We measured high-sensitivity cardiac troponin I (hsTnI) in 12 956 and BNP in 11 076 participants without cardiovascular disease in the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial before randomization to rosuvastatin 20 mg/d or placebo. Nearly 92% of participants had detectable circulating hsTnI, and 2.9% of men and 4.1% of women had levels above proposed sex-specific reference limits of 36 and 15 ng/L, respectively. hsTnI concentrations in the highest tertile were associated with a first major cardiovascular event (adjusted hazard ratio [aHR], 2.19; 95% confidence interval, 1.56–3.06; P for trend <0.001). BNP levels in the highest tertile were also associated a first cardiovascular event (aHR, 1.94; 95% confidence interval, 1.41–2.68; P for trend <0.001). The risk of all-cause mortality was elevated for the highest versus the lowest tertiles of hsTnI (aHR, 2.61; 95% confidence interval, 1.81–3.78; P for trend <0.001) and BNP (aHR, 1.45; 95% confidence interval, 1.03–2.04; P for trend 0.02). Rosuvastatin was equally effective in preventing a first cardiovascular event across categories of hsTnI (aHR range, 0.50–0.60) and BNP (aHR range, 0.42–0.67) with no statistically significant evidence of interaction (P for interaction=0.53 and 0.20, respectively).

Conclusions—In a contemporary primary prevention population, baseline cardiac troponin I and BNP were associated with the risk of vascular events and all-cause mortality. The benefits of rosuvastatin were substantial and consistent regardless of baseline hsTnI or BNP concentrations.